Africa does not just need more health funding. It needs smarter funding.
Africa does not just need more health funding. It needs smarter funding.
By Richard Gordon
If Ebola and COVID-19 taught us anything, it is that Africa cannot rely solely on outside funders to bail us out when the next health crisis arrives. Nor should we.
There has been real progress. Africa’s response to recent outbreaks has improved, and the Africa Centres for Disease Control and Prevention (Africa CDC) has taken an increasingly important leadership role. There is stronger African leadership and greater recognition that the continent must build and lead its own response.
But the underlying funding system has not evolved at the same pace.
Recent U.S. funding withdrawals have exposed just how dependent African health research remains on a relatively small number of external funders. The consequences have been deeply disruptive, but there is also a lesson here that we should not waste.
One of the biggest problems is not simply how much money is available for African health research and innovation. It is how that money is spent.
Too often, funders work in isolation, supporting valuable projects with the best of intentions, but without knowing enough about what other funders, governments, or organisations are already doing. This was a major challenge with COVID-19. The largest funding agencies had clear and sound strategies, but very few African-based entities were aware of what these were, causing confusion and duplication.
Addressing that fragmentation is at the heart of the African Health Research and Innovation Funders Forum (AHRIFF), which brings funders and ecosystem builders together to understand the wider funding landscape, identify gaps, explore opportunities to collaborate and challenge one another to work differently.
Good intentions, fragmented investment
Through the Funders Forums, I have seen the consequences first-hand.
At our second meeting, we discovered that four different funders were supporting essentially the same drug-manufacturing project. Imagine what might have been possible if they had known about one another’s investments from the start, aligned their objectives and put their collective resources behind taking one strong project further.
Instead, we had duplication.
And this is not ill-intentioned. People simply do not know what others are doing – and sometimes do not try hard enough to find out.
The fragmentation goes deeper than duplication. Funders naturally develop relationships with particular institutions, programmes, and researchers. But the result can be disconnected investments rather than a deliberate funding pathway.
Funder A supports a promising idea. What happens far less often is that Funder B helps take it through the next stage, Funder C provides the capital to accelerate it, and another partner helps take it to scale.
We saw this in 2025 when we looked at more than 15 entrepreneurship programmes supported by different funders. There was almost zero interaction with one another. There was considerable investment going into early-stage entrepreneurs, yet insufficient funding for the next critical stages – acceleration and scale. And we wonder why Africa is slower to build ecosystems – when the funders themselves are creating artificial barriers to entry.
You cannot build an ecosystem if everybody funds the beginning and nobody funds what comes next.
Funders can also enter an area without fully understanding what governments have already approved or funded. A new initiative arrives and is surprised by a lack of government support, only to discover that government has already invested millions in something similar for years.
Again, the problem is not necessarily the idea. It is a failure of alignment.
Building greater African ownership
This is where the lessons from Ebola and COVID-19 matter.
We have become better at responding, but we have not yet built a funding system that is sufficiently coordinated or resilient. That is the next challenge.
African governments have to invest more in their own health research and innovation systems. We cannot argue indefinitely that health security is a national priority while expecting somebody outside the continent to pay for it.
But governments do not have to do it alone. Governments, philanthropy and the private sector need to start seeing themselves as part of the same solution.
African governments also need to become more open to working with the private sector. Private capital represents one of the largest potential sources of funding available to us. It needs appropriate governance and clear public-interest objectives, but it needs to be part of the conversation.
Government also has tools beyond writing cheques. Tax incentives matter. Procurement matters. Regulation and policy matter.
If a philanthropic organisation is considering putting US$10 million or US$20 million into developing a health product, it is reasonable to ask whether the government will be prepared to buy that product if it succeeds. If the answer is no, we should not be surprised when investment goes elsewhere.
Collaboration needs to mean something
There are encouraging signs that funders and partners recognise the need to work differently.
The Beginnings Fund brought together more than 15 funders around US$525 million for maternal and newborn survival. Africa CDC’s Pathogen Genomics Initiative has brought partners together to strengthen genomic surveillance across the continent. And a partnership between the African Institute for Mathematical Sciences and Google DeepMind attracted 4 000 applicants for just 40 scholarships in advanced artificial intelligence training.
These are very different initiatives, but they demonstrate what becomes possible when resources and expertise are brought together around shared priorities.
We need more of that.
At the same time, collaboration is not automatically effective simply because several funders are involved. Pooled funding can create problems of its own if every decision has to satisfy the priorities of every organisation around the table.
The objective should not be collaboration for collaboration’s sake.
Sometimes the answer is pooling funds. Sometimes it is coordinating investments so different funders support different stages. Sometimes it is simply sharing enough information to prevent unnecessary duplication.
The mechanism matters less than the outcome.
We have already seen what bringing the right people into the same room can achieve. Connections made through the Funders Forums have contributed to collaborations and co-funding relationships, alongside smaller discussions focused on areas such as drug and diagnostic manufacturing.
When funders understand the wider landscape and identify where their objectives align, individual investments can become part of something much bigger.
From isolated successes to a better system
That is what I want us to build on when funders come together again in October.
The value of AHRIFF is not another conference or another set of presentations. It is the opportunity to turn individual examples of collaboration into a more consistent way of working.
I want funders to arrive willing to examine not only what we fund, but how we fund it.
How do we leverage one another’s investments rather than duplicate them? How do we take promising innovations from an early idea through to scale? How do we work with governments rather than unknowingly compete with investments they have already made? And how do we bring public, philanthropic and private capital together more effectively?
We also need to stop assuming that a model developed somewhere else can simply be imported.
Africa is not one country. More than 50 countries have different economies, health systems, research capabilities, regulatory environments and needs. We cannot simply plug in a European or U.S. funding model and expect it to work everywhere.
The disruption caused by recent funding shifts should be a warning, but it also gives us an opportunity. We can use this moment to build a stronger, more resilient system in which international funders, African governments, philanthropy and private capital understand how their investments fit together.
We already have examples showing that this is possible. The next step is to move from isolated successes to a funding ecosystem in which collaboration, alignment and shared ambition become the norm rather than the exception.
Africa will always need more investment in health research and innovation. But there is also enormous opportunity in making the funding already available work harder – connecting investments, filling gaps, taking promising ideas through to scale and building systems that can sustain them.
That is the opportunity I hope funders will come to the table ready to seize in October.
